For Future Doctors: Step by step approach to subspeciality in Medicine
I received a lot of queries regarding the steps and timeline to do subspeciality in Malaysia from various budding doctors who are about to complete their undergraduate degree. Even though I have mentioned some of the steps in my earlier articles under the “For Future Doctors” series, somehow a more detailed explanation seem to be warranted. So, in this post I will write in detail on how to become a Physician and subsequently a subspecialist. I will not touch on surgical speciality.I will write this article in a “frequently asked question” format based on questions that was asked by these budding doctors in my blog.
1) What is MRCP?
MRCP (UK) is a diploma offered by Royal College of Physicians of the United Kingdom. In UK, it is an entrance exam to speciality and everyone needs to pass MRCP in order to pursue their speciality training. In Malaysia, MRCP is considered as an exit exam where upon finishing the exam and completing 18 months gazettement process, you will be considered as a General Physician. MRCP is an internationally recognised degree and widely accepted worldwide.
2) How is MRCP conducted?
MRCP consist of 3 parts. MRCP Part 1 consists of 2 papers of 100 questions each. It covers basic science as well as clinical questions. The questions are multiple choice questions (MCQ) with “best of five” answers. You are eligible to sit for MRCP Part 1, 12 months after your graduation and medically employed. This means that you need to complete at least 1 year of housemanship before sitting for MRCP Part 1.
After passing your MRCP part 1, you will be given 7 years to clear your Part 2(written) and Part 2 (clinical). You can sit for either of the Part 2 exams at any time. If you fail to clear both this exams within 7 years, you will have to sit for Part 1 again.
Part 2 (written) consists of 3 papers of 90 questions each. The questions are multiple choice questions (MCQ) with “best of five” answers.
Part 2 (clinical) is a clinical/practical exam. It consist of 5 stations assessing you on history taking, physical examination, making a diagnosis, investigations, management and communication skills. Station 1 and 3 will have real patients with physical signs of cardiovascular, respiratory, abdomen and neurology. Station 2 is on history taking and Station 4 will be on communication skills of explaining certain medical diagnosis to patients etc. Station 5 consists of 2 brief clinical scenarios where you have to take a brief history and do quick physical examination and come to a diagnosis, simulating a scenario in a day to day clinic.
3) What are the passing rates of MRCP?
Generally, the passing rate of each part of MRCP is about 45-50% worldwide. Very rarely, a person passes all the part in first try.
4) How long will I take to clear MRCP?
If you pass all the parts in first try, you can complete the MRCP in less than 5 years; the best will be 4 years after graduation.
5) What are the other options in becoming a Physician?
The only other option in becoming a Physician is to do local Master’s programme by UM, UKM or USM.
6) I planned to work in medium-sized hospital in Sabah or Sarawak to learn as much as I can without too much competition (HO overflow). but your advice is after I pass part 1 and 2 MRCP, I should apply for transfer to bigger hospital for training purposes to handle part 3, even if I’m in a rural hospital?
First of all, there are only few hospitals in Sabah and Sarawak which can take housemen, namely Kuching, Miri, Sibu, probably Bintulu soon, Queen E and probably Sandakan/Tawau hospitals soon. Rest of the hospitals do not have consultants to supervise housemen. As long as the hospital have consultants and has adequate training facilities for junior doctors, you should be able to sit for MRCP. Unfortunately, only major hospitals have adequate specialities for you to train as a physician. You must understand that MRCP is not just an exam for you to sit and pass without adequate clinical knowledge. You can sit and memorise all the textbooks but you will not be able to pass MRCP if you do not practise clinical skills. As far as possible, you need to undergo rotations in various subspeciality units to get adequate clinical knowledge before sitting for MRCP. Rural hospitals do not have subspeciality units for your training. That’s the reason, it is better to do your training in big general hospitals.
Furthermore, you need a supervisor who can testify that you are fit to sit for the exam, especially for Part 2. Thus, you need a proposer who can certify that you have undergone adequate training to sit for the exams. After passing all the parts, you also need a MRCP holder of at least 8 years to sign the testimony to receive the diploma.
7) What is gazzetment process?
Since MRCP is not a specialist exam in UK, Ministry of Health of Malaysia has made it compulsory for you to complete 18 months of gazzettment process before being recognised as a specialist and to receive the specialist allowance. Thus, after 18 months of further training in a tertiary hospital, you will have to get your HOD to recommend you to be gazzeted as a specialist. The gazzettement period can be shorter on a case by case basis depending on your duration of training before passing MRCP. This will be decide by MOH gazzettement committee.
8) After the gazzetement, what’s next?
How do I apply for sub-specialty training? Where do I apply? Can I apply while I’m still under the gazzetement process? Will I be accepted as soon as I apply, or it’s subjected to seats availability? In short, I would like to know about the sub-specialty training, and maybe as specific examples, you can tell me the route on to cardiologist and neurologist.
After gazzetement, you can apply for subspeciality training via Ministry of Health. Depending on the field of subspeciality that you are applying, the waiting time can vary from few months to few years. Popular fields like cardiology and gastroenterology take the longest time to get a training post. At the moment, subspeciality training in Malaysia can only be done in Ministry of Health hospitals or University hospitals. Only certain hospitals are designated for certain training. For example, cardiology training can be done at Penang Hospital, Serdang, Kuching and JB, as far as I know. Neurology is usually done in HKL and Penang.
Most subspeciality training in medicine is for 3 years. Usually, you need to do the training in 2 different centres. The final year can be done as an attachment overseas and you may be given a fully paid scholarship by MOH. From 2011 onwards, you need to sign a contract upon confirmation of your training post in subspeciality by MOH. You will be bonded for 3-5 years depending whether you do all your training locally or partially overseas. Previously, you are only bonded if you choose to go overseas during your final year.
All in all, it will take roughly 10-12 years upon graduation for you to become a subspecialist.
9) If I got accepted by Singapore as MO post-MRCP, is it certain that I will be absorbed into the sub-specialty training after 1 year? After I have completed my specialist training in Singapore, is my license recognized in Malaysia, and is my license recognized internationally for that matter.
There is no guarantee that you will get the subspeciality training post in Singapore. It depends on your performance and which field that you are choosing. If you stay long enough, you will get it, as long as you show interest and your superiors support you. Subspecialist training in Singapore is a very structured training programme and well recognised internationally. There is no problem for you to return to Malaysia as a subspecialist.
10) Is Malaysian specialist license recognized internationally? And what are your recommendations for internationally recognized sub-specialty programmes post-MRCP?
This is a difficult question to answer. Whether another country recognises our subspeciality training depends on that particular country. Generally, our local Master’s programme is NOT recognised elsewhere except for some Middle East countries. So, it is very likely that as a Master’s holder, you will not be able to work elsewhere as a specialist except on attachment basis. Certain countries like Australia have their College of Physicians to assess the particular consultants experience and then will decide whether you can be recognised as a sub-specialist.
11) What is FRCP?
After 8 years of holding MRCP (UK), you can apply to the respective college for FRCP(fellow of the royal college of physician). To be accepted into a college as a fellow, you need to have contributed a lot to clinical medicine and medical educations. Publications in journals are also important. Furthermore, you need a proposer who is a FRCP holder to propose you to be accepted as a fellow. The respective college councils will go through your CV and publications before deciding whether you can be accepted as a fellow. Being a FRCP holder gives you an international recognition in medical field.
For more info on MRCP, please visit http://www.mrcpuk.org/SiteCollectionDocuments/MRCP_Regulations.pdf
phew, now i know how long the training is. Thanks for the info btw
Thanks doc for this great article.
im final year medical student.i still have some inquiry about MRCP.
1)Can we just take MRCP and the gazette but didnt complete the subspecialty training?what line of job can we get if we didnt complete the subspecialt?
2)if i want to be an oncologist,what is the steps for it?
3)after i get the MRCP can i go to work in uk?
4)how much is the cosot to sit for MRCP?can we get a sponsor?
1) you can work as a General Physician/Internal Medicine Specialist after gazzettement. However, in private sector, the prospect is better if you have a subspeciality.
2) You need to do Master’s in Oncology
3) you can work in UK after MRCP but you must remember that MRCP is NOT a specialist exam in UK, only an entrance to speciality training.
4) Part 1 and 2(theory) can cost about 555 pounds each and Part 2 (clinical) is about 1000 pounds. The current exchange rate is about RM5, if I am not mistaken. The more number of times you sit, the more it will cost. NO sponsors!! you own money, my friend
thank you doc for answering my question.i have further question.
1)You said that MRCP is an entrance to specialty training in uk,that means we have to do a specialty training for about 3 years to become the general physician.am i right?so if i have done the subspecialty training in malaysia and become cardiologist for example and want to work in uk,is it is recognized by GMC or not?do i have to sit for a test again?
2)if i finish doing my housemanship here in uk,and want to come back to malaysia to work as MO is it acceptable or do i have to start again as house officer?
3)What subspecialty training that u will recommend for me after taking the MRCP?
thank you again doctor.May GOD bless you.
Usually, in UK, after you complete your MRCP, you can gain entry to your field of subspeciality training. After becoming a cardiologist, it is up to the GMC whether they recognise your training as a subspecialist and how many years you have practised as a cardiologist. You may need to show some proof of your training. Same like in Australia, where the colege of physicians will decide whether you can recognised as a cardiologist.
Even if you have finished your Housemanship in UK , you need to complete the remaining postings in Malaysia(as housemanship is 2 years in Malaysia) before they give you the full registration, unless you come back after MRCP/as a specialist.
What subspeciality you choose, you can decide after completing your housemanship!! I had many friends who wanted to become this and that during student’s time but ended up doing something else. You will only know your interest after you start to work. Student life and working life is totally different!
Dr Pagalavan,
I was thinking of taking master degree for Physiology after graduating, and perhaps, work in the academic world. Could you please point out the roads to get there? thanks!
you need to do Master’s in SCience (Physiology) programme offered by some of the local universities.
Dear Dr Pagavalan,
a very great update on this! I heard that one should have at least 4 years of medical experience and waiting for another 18 months post MRCP before one can apply for gazzetement. meaning to say if a candidate completes MRCP 3 years after graduation (including housemanship 1 year,MO ship 2 years),he has to wait for another 3 and half years!
what is your comment?
your 2 years MOship is considered as part of the 4 years. Out of 18 months, the first 12 months is also considered as part of the 4 years training. Means you will only have to add another 1 year additional and not 3 and half years! However, most people will take atleast 3-4 years post housemanship to complete all 3 parts of MRCP. Generally it will be just nice.
Allow me to comment on this as well. As me too, have enquired it with the ministry officers.
The criteria set in the DG circular (many years ago….can’t remember but it was before year 2000), you need to have 4 years experience in the speciality you are requesting for gazettment. Meaning to say, you need 4 years being in medical department before being allowed for gazettment upon completion of MRCP (ie. the 18 months). But 12 months out of the 18 months can be counted towards that 4 years experience requirement. Meaning you need to make sure you are already 3 years in medical department before completing your MRCP so that the moment you have passed, it will be just right. The final 6 months of the 18months are the actual gazettment period. Sometimes, if you have experience in the district hospital as MO, it can be counted towards your 4 years experience as well.
Well, having said that, there may be exceptions, but who and how one is exempted, I do not know. Maybe Dr Paga can shed some lights on his experience with this?
Dear Dr. Paga, may I ask you for comments on various pros and cons of each subspecialities available in Malaysia. For instance, cardio, gastro, hepato, haemato, endo, rheumato. With more and more sub coming up, like palliative, geriatric, rehab, etc….it becomes difficult to choose your sub. I do agree, it boils down to what you want to do. But will be glad if you can spare some time, discussing on these subs, its prospects in govt and private, its workload and environment, and of course job satisfaction.
Thank you
Thanks for your information. Do you know whom to deal with in MOH after passing MRCP? Should we need to inform MOH immediately after passing MRCP?
Yes, you need to inform the Bahagian Perkembangan Perubatan immediately after passing MRCP. Only then you gazettement process starts. You may also be transferred to another hospital.
This is exactly what I was looking for. Thanks for wriitng!
Dear Pagavalan..
I want to ask u regarding the MRCPCH programme..
(1)if i take the MRCPCH paper one year after my housemanship…and i am posted to other departments (not paediatrics) during my medical officer..is it included in the 4year requirement??
(2)And if i pass my MRCPCH all parts..can i work at other country like australia to earn my specialist title without the 18 months of gazzetement at MOH?
(3)If i am able to work at other country to earn my specialist title..is it recognised in Malaysia or I stil have to undergo the gazzetement if I want to come back Msia to work??
Thx…hope to hear from u soon!
1) not necessary, it must be paediatric posting
2) NO, Australia do not recognise MRCPCH or MRCP. In Singapore you can get a registra post.
3) If you are already a gazetted specialist in another country then it depends on your seniority and the tupe of postgraduate training. I know some who came back from Taiwan were asked to do certain months of gazettement in government hospitals.
Dear Pagavalan..
Sorry for keep on asking you questions..
(1)your answer for my question number one is it mean i nt necessary have to be in paediatrics department for 4years or it must be necessary??sorry because i do not understand the way u answer the question….
(2)So which paediatrics programme does Australia recognise?
Reali sorry for troubling you to answer my questions..but i really need some to enlighten me..thanks!!
You need to be in the paediatric department. Furthermore, you can’t sit for Part 2 if you do not have certain amount of clinical training in paediatric.
Australia only recognises their own postgraduate degree and those who completed CCT in UK.
Hi Dr,
Is it true that you cannot do your housemanship and MO training in the same govt hospital? I was planning to do my housemanship in Penang GH and stay on there, but heard from some friends that you have to choose a different hospital after that. I understand that you will need to do the rural posting, but can I go back to Penang GH after that and continue on as an MO to carry out MRCP training?
Thanks!
Yes. Most doctors who completed housemanship will be transferred out. AND there is no guarantee that you can return to Penang GH after your rural postings. With the increasing number of doctors , this situation will get worst.MOH wil decide on where you will be posted.
hello Dr Pagal,
happy new year,
heard a lot about subspecialty training. rumour has it is that post gazettment as a physician we still have to wait for 2 years to be eligible to apply into subspecialty training, is it true?
had try to ask for the specific circular saying so but not avail
some flip flop policy again?
now there are news that newly gazetted physicians been posted out to secondary hospital and east malaysia. well that’s true
pls enlighten
thanks
Yup, I heard you can only apply for sub 1 year after your gazettement. Depending on your sub, it may take another additional 1 year.
Hello, Dr. Pagal,
After passing the MRCP, can i go to UK for specialist training since it is an entrance exam for specialisation?
As for the training in UK, we can ask for sponsorship from government right?( although i think that we’ll be bonded for the whole life for jpa scholar)
Thanks.
You can apply but the chances for you to get a post is very slim due to UK immigration laws implemented since 2007.
No, government do not sponsor you. Only when you are in the MOH subspeciality training programme, you may get sponsorship to go overseas for the final year of your training( which is 3 years)
Hi Dr Pagal,
I am now still a medical student. Concerning about the master programme in Malaysia being not recognised in other countries, I am wondering is it possible for me to do MRCS in Malaysia but FRCS in the UK?
If I am going to just stay and work in Malaysia, do you think it is better for me to do my master and training in Malaysia, rather in the UK? What can I do if one day I want to work in Singapore?
Thanks.
Getting a job in UK is not easy due to immigration law. Getting into their training post for speciality is even more difficult nowadays due to stiff competition from EU citizens etc. That is the reason why many are returning to the country. With the local Masters, you can’t be recognised as a surgeon in any other country. You may be able to work as a registra. MRCS may be helpfull then.
Dear Dr,
Since getting a job and training post is difficult nowadays in UK as what you had advised. Would appreciate your comments : -
(1) At present, I understand that all Malaysian medical students are still allowed to do their internship in UK to enable them to register with the GMC. Do you have the statistics on how many of these young doctors could not get a hospital posting upon completion of their 2yrs internship and will force to return home?
(2) In the event these young doctors have to return home since there is no job in UK : -
(a) Is there any guarantee that all of them, if not most of them, will fare better than all our locally- trained in UM, UKM or IMU in term of career advancement?
(3) Are their success rate of passing MRCP, get a place in our Master Programme,and promotion, etc, etc. are higher than most of our locally-trained?
(4) that all of them, if not most of them, need not work/study hard to pass MRCP or any other pre-qualifying exams for specializations compared with all our trained locally just because their degrees are more recognized by other countries, such as Singapore?
(4) Will our Malaysian government give special preference to these group of UK trained young doctors ? such as postings to bigger hospital, a higher salary, faster promotion? Better allowances? since they had spent million of Rgt in their overseas training? (their own money without scholarship from the government).
If the answers on the above are all “No”, then it is my personal opinion that it is not worth spending million of Rgt just to get an internationally recognized basic MBBS and at the end of the day you cannot get a job in UK..
A medical career is a long and winding road, I read your link on the steps to steps to sub specialization which is very informative to all our young doctors, I believe with determination, those locally-trained doctors will be as successful as these overseas- trained doctors who cannot get a job in UK, without having to spend million of Rgt.
I know it is the prerogative of an individual who chooses on how to spend his money as long as he can afford. I am therefore not referring to the rich who can afford to spend million of Rgt, but rather on those who spend all their life saving money sending their children oversea for medicine, but at the end of the day, their children cannot get a job in UK or Singapore and have to come back to Malaysia.
What say you, Dr?
Williams
1) I don’t really have the statistics but from what I gather, more and more of them are coming back after housemanship in UK. The very competent ones may be able to get a job there.
a) There is no guarantee in terms of carrer advancement. It depends on how good you are and the oppurtunities.
3) Generally, most graduates who graduated from UK would have sat for MRCP before returning to Malaysia( atleast Part 1& 2). The passing rate is usually higher when they are trained in UK. In terms of Master’s and promotion: no difference.
4) Generally as I mentioned above, most UK graduates would have cleared their Part 1/2 before returning.
4) NOPE, our government do not give a damn. The bigger cable you have the better posting you will get. Welcome to Malaysia! The salary, promotion etc is the same like any other government servant in Malaysian civil service.
I have always said this : spending huge amount of money or taking huge loans to do medicine is worthless. You will never get back the money. Having said that, when the situation in Malaysia gets worst with no job oppurtunity, having a well recognised degree will open more doors for you. Of course, nothing is guaranteed in life. In near future, almost all countries will have surpluss of doctors. BUT countries like UK, Australia are producing just enough doctors for themselves unlike Malaysia which is overproducing with no quality.
Hi Dr Paga,
I’m interested in specialising in family medicine, can you please give me some insight about the pathway to obtain it? Any subspeciality involving family medicine? Thanks~~
Either Master’s in Family medicine or you can try FRACGP , conducted by the Academy of family physician malaysia. you can visit their website for info
Hi William,
I have many friends’ children working in Australia or UK after their MBBS. Many of them did not get into specialization even after many years staying on there. They remain working in the sub-urban or rural hospitals and some of them are on contract basis hopping from one hospital to another hospital.
Being an Asian PR over there, they also face discrimination just like our quota system here. It is not true that they earn more as doctors there and live a better life there as compared to our doctors here in Malaysia, the reasons being : -
(1) Their tax margin is very much higher.
(2) They may earn Aussie dollar/pound but their purchasing power is the same as those Malaysian doctors earning ringgit par to par in terms of cost and standard of living. Bear in mind that the cost of living there are very much higher, especially in UK most cannot even afford a car as petrol and parking cost are very high compared here in Malaysia.
Unless you are earning Aussie dollar or pound and spending them in Malaysia. This is the reason why many western tourists like to have holidays in Malaysia because they can spend like the rich and famous back home.
(3) I know only very few of their children get into specialization. They are the lucky ones just like those Malaysian doctors here get into the master program or pass their MRCP, etc. Of course they also worked very hard to achieve this.
(4) In fact my friends said the Aussie Hospitals are cutting down the overtime/allowance of housemen just the same like here.
Since they are not returning home as specialist category or scale so there is no special treatment or exemption for them. It is made worst when they have to compete with the younger Msian doctor here in term of length of service for promotion, etc. So most prefer to stay on there (as chronic doctor or on contract basis ) because they have no choice. It is not true that they stay put there because they earn more and live a better life than Msian doctors here.
My message here to all aspiring doctors, either you are overseas-trained or locally-trained, if you want to be a doctor, you should take it as a profession of your choice to make a living for yourself or your future family (everyone must work to make a living, unless your family has left you a big fortune), not so much that you will earn big money being a doctor trained overseas and then stay put overseas.
Dr Paga is locally-trained, but he made it to be a Consultant Physician & Rheumatologist and I believe he had made a lot of hard work to achieve this.
Karen
Excellent points. Just a few quick notes:
(1) Yup, tax hits 48% after awhile.
(2) Cost of living is not very high at all. You missed out on the BIG thing: Property prices. They are seriously seriously insane. Expect to slave off to pay the mortgage.
(3) Specialization is difficult regardless of which country you are in. In most countries, you need to be accepted into a college (or association) of specialists. And they rightfully guard the high standards of the profession. Getting into a program isnt hard, but completing all the requirements is a royal bitch. You also need to pass rigorous exams….both written and clinical to be accepted into the club of specialists so to speak.
(4) Cant speak for UK hospitals, but Australian hospitals are under pressure to _NOT_ overwork anyone. There are very strict guidelines on what happens if someone (not just clinical staff) work overtime. The unions are strong. Enterprise agreements negotiated by the unions are to the effect that once you work overtime, they literally pay through the nose for your services. Currently, even at PGY1 (intern) salary rates, overtime pay is 2x normal pay, or ~AUD$60/hr (RM180/hr). This is the real reason why they dont like giving people overtime…and understandably so.
One difference between these countries and ours is the price of education. Most of these countries give free education to their citizens. Thus, many do not mind paying the high tax as they do not have to worry about their children education.
Even those (Aussie PR) who can afford to buy a house there will usually stay very far in the suburban because the house at suburban is cheaper. My nephew who is a Malaysian graduate and was transferred there 5 years ago, works as an engineer in Melbourne city. He stays 40 km away from the city and travels daily by train to office. He said life is boring but not so hectic and stressful as back home because there is no overtime. But he prefers to work overtime and get some extra income. They used to have a maid in Malaysia but now everything he and his wife have to do themselves. His is a PR now and his reasons of staying put there is for the future of his three young children, in term of education and job opportunities.
I do not really agree with him. I have friends who had spent huge sum of money getting PR status for the whole family and their children also managed to get into the public universities there. But upon their graduation, many prefer to return home because they cannot get a job related to their course or of their liking (most commerce, computer and finance related). Worst still, some of them when they are back home in Malaysia, they also do not get a job of their choice.
I was in Australia this March, I met a Business Commerce graduate doing part time as hotel cleaner to get some pocket money. She is a Chinese Australian (born there). She has been looking for job for many months. I also met a science graduate who works (born there too) in a Chinese restaurant because she is still waiting to get a job related to her course.
Life in overseas is tough unless you migrated there with lot of money. The situation there is the same like Malaysia, many international students and PR graduated in Aussie but do not get a job of their choices even though they have recognized degree and results. In fact, most of my friends’ children are graduates of the group of 8. Being a PR there, it is also not easy to get critical courses like medicine. It is very competitive just like getting a place in Malaysian public university for medicine.
Of course there are some very successful cases but they are the lucky ones. My message here is to some parents, please do not spend all your life-saving money sending your children for an overseas education regardless of what courses, with the hope that they will fare better in term of life and career. There is no guarantee. It is when one enters the workforce, his personality and work attitude matter the most. and also a bit of LUCK and opportunities.
There simply isnt any free lunch anywhere…
What alot of people dont realize is that once you take away the privilege enjoyed in Malaysia (being upper/middle class), you will have to compete with other similarly privileged people.
Even in the absence of discrimination, many middle-income chinese students find it genuinely difficult to get a place in Medicine. Why? Because intakes are small relative to the number of applicants. It’s competitive and there’s no discrimination hooray! But dont forget, you are competing against other middle class people born and raised locally (Australia/UK/US). It’s not Malaysia where it’s relatively easier to be in the top 1-2 percentile –> In Malaysia, if you can afford tuition etc your grades will be above the rest.
The “middle class” advantage is gone when you study abroad… as you are competing with alot of average middle class joe’s and jane’s.
Medicine is still bloody competitive to get in, and being in the top 1-2% of graduates is genuinely harder in first world countries. Even in the absence of discrimination, there is no guarantee you will get in and there is quite a bit of hard work involved.
I dont mean to sound elitist or anything like that, but in my opinion, there seems to be a small percentage of people (irrespective of race) who are bright and capable. A smaller portion of this small percentage would be genuinely interested in medicine… and they are the diamonds in the rough that medical schools try to recruit –> hence the interviews and high academic cut-offs.
Yup, nothing is guaranteed no matter where you graduate from but being a graduate of a well recognised university do give you an advantage.
There are + points to own a well recognized degree for non-medical courses like banking, law, commerce, IT, etc, as the private sectors always prefer to recruit overseas-trained graduates, especially the banks.
It is not necessary for medicine if you are genuinely good and interested in medicine. Eventually all have to work in the government hospitals to pass their internship, to sit for the numerous rigorous written and clinical exams before they can quit to private hospitals as a specialist.
As for private medical schools, if you can afford, try to go for those more established medical schools. IMU is established. Monash I think is alright too even though it is new. Both their fee are expensive but still cheaper than go overseas, or Perdana University, Rgt 800,000 for its undergraduate MBBS (Ireland)! How about living cost for 5 years away from home? They claimed that the tuition fee is high because the lecturers are ‘imported’ from 1st world countries.
Even if you have a MBBS from Melbourne or Edinburgh but being a non PR or citizen, you may get an internship, but training posts priority will be given to their citizens who are from the 2nd tier medical school. As it is most government policies. Also if you are a citizen but an overseas- trained MBBS, when you apply to do your HO back home, the postings will be given to those citizens who do their MBBS locally, if there is a housemen glut, So. you ‘rugi’ -lah!!!
As for courses that allow you to work in private sectors upon graduation, it is a different issue. if you are from Oxford or Harvard, obviously you can compete well with the local (Aus/UK/US). Even so, most governments are using immigration laws to restrict the employers so as to protect the interest of their citizens. If you are returning home to work, then it is fine.
So for those local MBBS who are ambitious to go far as a specialist or want to migrate to other countries, just sit for all the required exams and you may make it. It is not only our local MBBS is not recognized elsewhere, most countries MBBS are not recognized elsewhere too. Even if it is a well recognized degree, you still have to go through some training in that country, unless you go there as a specialist. So why feel so bad about ?
At least there are exams for you to realize your dream, even though they may be very tough, as what Mint Berry Crunch said, there isnt any free lunch anywhere. Even with a well recognized degree, you still have to sit for MRCP, etc, etc before you can be a specialist. You are not exempted from those exams. So work hard and cheers, if medicine is your passion!
Want to ask about working in Singapore. I’ve just passed my MRCP, how’s the training in Singapore for the specialist? FYI, I’ve only 2 years experience of MO and 2 years HO. Which post can I apply? MO or registrar? How can I be a specialist there later?
I have answered this somewhere else. Passing MRCP does not make you a specialist in Singapore. You can get a MO post. Depending on the availability of post, you may get a specialist training post later. No guarantee.
hello Dr.pagalavan…i’m doing my housemanship in one of the hospital in malaysia…i intend to do psychiatry course even during my med school time.is it possible if i want to specialisation in psychiatry in overseas and then come back n work in malaysia…meaning i’ll be leaving housemanship for the time being…n if let’s say if i manage to complete my specialisation,do i need to do my housemanship again?tq.
If you leave housemanship, you will get into trouble unless you complete the housemanship overseas. Thus, I would advise you to complete your housemanship first. Whether you can come back and call yourself a psychiatrist or not, depends on whether your training is recognised in this country.
Dear Dr,
how to apply mrcp (uk) part 1 in malaysia center?
i am a HO in Msia.
asking on behave of a friend,
in order to specialized in family medcine, if she (HO, 2 months left) did not want to go through master programme, the only way is through AFPM.
but in terms of application: when can apply, when can sit for paper etc is not clearly stated in the web site. Like mrcp (such that part 1 after 1st year HO). which is clearly stated. Do u know any detail about it?
to my understanding, she had search the AFPM web site but cant find any detail about it.
thanks and have a nice days.
The AFPM programme is a 4 year structured programme via long distance learning. You need to be fully registered with MMC before applying for the programme. After 2 years, you wil sit for an exam to receive Diploma in Family Medicine. After another 2 years you will need to sit for Part 1 and if you pass, you may sit for Part 2.
contact UM medical faculty
Greetings Dr. Pagalavan,
Just to ensure that I got my facts correct to plan for my kid’s education.
1. The MRCP examination is conducted in Malaysia, right?.
2. After graduating with an MBBS/MD degree from a local private university, and after serving the required number of years as you have written, the candidate can seat for the MRCP locally in UM, UKM and USM, right?
Best regards,
hi, great parents!
how i wish my parents will plan for me… haha
1. yes
2. yes but i am not sure how is the pathway of application… waiting for expert’s reply…
nice days
1) Yes, once a year and once a year in Singapore
2) MRCP is only conducted in UM
Greetings Dr. Pagalavan,
I am trying to search for your respected writings on doctoring in the military (Malaysian Armed Forces) but unfortunately I fail to find one. Perhaps I missed out some posts. Please do let me know if you have written on the subject matter.
If not, then, perhaps, you would want to write one. Since there will be a glut of doctors in the non military sphere, perhaps, serving with the armed forces is an option. How does one go about being a doctor in the armed forces and what are the carrerr path in terms of specialization, sub specialization etc.
Best regards.
At the moment, housemanship cannot be done in Military hospitals. You still need to complete your housemanship in MOH hospital before applying to ministry of defence hospitals. There are not many military hospitals in the country, less then 5. They do sponsor their doctors for specialisation at local Master’s programme but depending on their need. Eg: i was told that they do not sponsor anymore doctors for Master’s in Orthopaedic as they have enough orthopaedic doctors. They use to have a better salary scale before but it is the same now.
Thank you very much for your kind responses.
Dear Dr,
I understand that the medium of instruction in private medical school in Malaysia is in english, how about public medical schools, is it in BM?
English
Thanks, Dr.
Hello Dr,
I am currently working in the UK as a medical SHO (3 1/2 years post graduation), and have got my part 1 and part 2(written) exams. My husband has just received a great job offer in malaysia and is contemplating coming back home.
My questions are:
1) since I did my housemanship here (medical, surgical, ortho, A+E, ITU), at the current level I am, will I have to do HO rotations in gynae and paeds, even though I clearly want to do internal medicine?
2) If I return to malaysia with my MRCP (inc PACES), will I be able to skip doing the HO rotations?
It is better for you to come home after completing PACES. Then you just need to do the gazettement process. If not they may ask you to complete the remaining HO postings.
Without the O&G rotation, you will not be registered with MMC. You need to complete this rotation which is a compulsory posting.
Thank you very much for your input doctors.
Poor Doctor, does that mean that even if I have completed PACES, I will still need to complete the O&G rotation to register with MMC, and then do the gazettement process?
I know a few with MRCP who were exempted by MMC.
That one probably is a senior doctor not fresh or recent MRCP holder. My hospital got a senior cardiologist from Singapore and accepted by MMC for full registration without the need of HOship or compulsory service.
Usually they must have worked for about 5 years overseas
dear dr,
im a medical student from a private uni in malaysia. I entered the uni with O and A levels results and am wondering if that will pose a problem in aplying for housemanship in malaysia later. As from what i see from SPA official site, they need a SPM at least for application.
May I ask if applying for housemanship in another country is possiblle after getting the medical degree from malaysia? thank you
What you need is atleast a credit in BM paper to enter a permanent job in government service. Thus, you need to sit for BM paper.
None of our medical degrees are recognised overseas except UM/UKM is recognised in Singapore and Monash in Australia. Thus, if you have any other degree, you can’t do housemanship anywhere else.
dear sir, is there an alternative to the standard BM SPM paper? And when is the best time to take the exam?
thank you for your attention
It has to be equivalent to SPM paper. You can sit for the SPM BM paper anytime.
Sir, I do have a Bahasa Melayu in O levels, is that equivalent to the SPM BM?
was it a national level exam? If so, then it may be considered equivalent.
Thank you very much for your replies sir. Have a great day
Yes, I took the exam at a national level. Thank you for your replies, they helped alot. Have a great day
Dear Dr,
Im interested in enrolling for MRCP exams during housemanship. Can I request for your expert advise? I would also like to do housemanship in Sarawak hospital. Does it help in the preparation for MRCP exams later.
Thank you again for the time and attention.
MRCP Part 1 can be sat 1 year after graduating.
It does not matter where you do your horsemanship
Hai sir, when u think a person should start prepping for mrcp? Immediately at the start of housemanship?
Up to you!
Or how long it took u for prepping?
For Part 1, atleast 9-12 months
Received with thanks
dear dr. pagavalan,
i really appreciate your blog as it keeps me up to date with the malaysian healthcare developments.
i just want to ask, what are the most needed specialties in malaysia for the moment? i did a hospital attachment in kuching last year and i was told that there’re only 2 chest physicians in the whole of sarawak which sounded quite outrageous.
i’m currently inclined toward orthopedics, gen surgery and emergency medicine and am prob gonna try complete my specialty overseas first before coming home to serve. what might the prospects be like for those specialties and would they be helpful in msia or are there too many of such specialists already?
hope the questions aren’t too bothersome!! >.< would really appreciate your input though! thanks so much!
Btw, wd chest physician means? Cardiologist? Cardiothoracic surgeon? o.0
Probably Respiratory or Pulmonology?
Respiratory physician
Every speciality is needed at the moment but situation may change in the future. Ortho is the least needed.
Yes, we are short of chest physicians. So do Haematology, oncology etc etc
Why Ortho is the least needed ?
Is Malaysia producing too many othopedic surgeon ?
How about demand for general surgeon ?
I have answered this question before
erm.. if am not mistaken..
cardithoracic is a subdiv of surgery: cardiothoracic surgeon…
cardiologist n chest physician is both subdiv of internal medicine sp: being cardiologist those related to the heart; MI SVT n bla bla…
chest physician is the respiratory systems mainly: the PTB n lung ca all these…
Yes
thanks a lot for the input! sorry for the confusion, i did mean respiratory physician.
i managed to locate some of the comments for emergency med, surgery and ortho. you really do get a lot of similar questions! i feel bad for posting mine before attempting to search. though the comments were spread out over multiple different posts.
it was mentioned in one particular comment thread that ortho is the most popular masters program in msia. am quite surprised because this is not the case where i’m studying (hong kong). may i ask why it is that ortho is so popular in msia? (hopefully it hasn’t been discussed somewhere else already)
and what about trauma surgery? in some countries like australia and the u.s., trauma surgery seems to lean toward that of general surgery while in hong kong and probably the uk, trauma surgery is more within the subset of ortho. is it a popular subspecialty in msia and it more to the ortho or gen side?
much thanks!
It is popular in Malaysia because it is considered one of the easiest field and easiest money making field. We have the highest road traffic accidents in the region!
WE have trauma surgeon in both general surgery and orthopaedic surgery. They usually form a team. However, this is only applicable in government hospitals. In private, every ortho and general surgeon will also claim they are trauma surgeons.
Thank you for the kind informations Dr.Pagalavan
im here would like to know wether,i can sit for MRCP if i didnt do any internship
upon graduation?
i have followed my husband right after graduation to US,i passed my USMLE step 1 and 2 but didnt get any position in match..im thinking of doing MRCP order to back malaysia.
Do i need to step as houseman in malaysia order to apply for MRCP?
can you please advice me?
I think u need some kind of certification that u are already an mo to take mrcp 2. Which means u must do internship.Im not sure though. I thought the usmle match is not yet?like in a few months time?
it is not easy to get matching nowadays.
As far as I know, you can only sit for MRCP Part 1 after 1 year of service/internship
Hi, Dr.paga. This might sound out of topic but can you state which job in healthcare department that is currently in demand? And do you think law offers a bright future?
Medical Law